Value-Based Purchasing
FEATURED ARTICLE
Cross-Agency Strategies to Curb Health Care Costs: Leveraging State Purchasing Power
/in Uncategorized Reports Administrative Actions, Cost Containment, Cost, Payment, and Delivery Reform, Health Coverage and Access, Medicaid Managed Care, Prescription Drug Pricing, State Rx Legislative Action, Value-Based Purchasing /by Jane Horvath, Ellen Schneiter, Christina Cousart, Trish Riley and Maureen Hensley-QuinnRising health care costs are an intractable problem in the United States, but states, faced with balanced budget requirements and growing voter concern, aren’t waiting for a federal solution. This report explores state initiatives to curb health care costs by: Leveraging Medicare’s well-established reimbursement rates as reference prices for state employee plans to address rising […]
Hospital Price Transparency: The Next Frontier
/in Uncategorized Colorado, Maine, Massachusetts, New Hampshire, Washington Blogs Cost Containment, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health IT/Data, Medicaid Managed Care, Value-Based Purchasing /by Josephine PorterThe Centers for Medicare & Medicaid Services (CMS) took an important first step toward increasing the transparency of hospital finances when it required hospitals to post their charge information, effective January 2019. But, these charges are not prices paid — they are typically the starting point against which commercial payers negotiate discounts. States with all-payer […]
NASHP’s Health and Housing Institute Celebrates First Anniversary
/in Uncategorized Blogs Community Benefits, Cost, Payment, and Delivery Reform, Health Equity, Housing and Health, Population Health, Social Determinants of Health, Value-Based Purchasing /by Malka BerroThis month, the five member states of the National Academy for State Health Policy’s (NASHP) Health and Housing Institute are marking their first anniversary of breaking down agency silos and advancing reforms to improve health and housing for vulnerable populations, including those experiencing homelessness, struggling with behavioral health or substance use disorders, or transitioning out […]
The State of States’ Health Policies: What Governors Highlighted in their 2019 Addresses
/in Uncategorized Blogs Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Cost Containment, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health Equity, Housing and Health, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Population Health, Prescription Drug Pricing, Social Determinants of Health, State Insurance Marketplaces, State Rx Legislative Action, Value-Based Purchasing /by Anita CardwellState of the state and inaugural speeches give governors the opportunity to highlight their recent policy successes and outline key plans and priorities for the coming year. These speeches are strong indicators of governors’ policy goals and often include proposals and funding recommendations for their legislatures. As a result of 2018 gubernatorial races in 36 […]
Guest Blog: Massachusetts Report Recommends More Health Care Price Transparency and Simpler Payment Methods
/in Uncategorized Massachusetts Blogs Administrative Actions, Cost Containment, Cost, Payment, and Delivery Reform, Prescription Drug Pricing, Quality and Measurement, State Rx Legislative Action, Value-Based Purchasing /by Amara Azubuike and Sandra WolitzkyAmara Azubuike and Sandra Wolitzky are assistant attorneys general in the Massachusetts Office of the Attorney General. A new report released in October 2018 by Massachusetts Attorney General Maura Healey finds that complicated and varied methods used to determine health care payment rates contribute to administrative cost increases and make it difficult for market participants […]
Toolkit: Upstream Health Priorities for Governors
/in Uncategorized Toolkits Behavioral/Mental Health and SUD, Chronic and Complex Populations, Community Health Workers, Cost Containment, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Featured Policy Home, Health Coverage and Access, Health Equity, Healthy Child Development, Housing and Health, Long-Term Care, Maternal, Child, and Adolescent Health, Medicaid Expansion, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Medicaid Managed Care, Palliative Care, Population Health, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing, Workforce Capacity /by NASHP WritersGovernors can control costs, advance their priorities, and enhance lives by improving the social and economic conditions that make up 80 percent of the factors affecting their residents’ health. Governors are uniquely positioned to maximize state resources to address the conditions affecting health by leading cross-agency and public-private collaborations, leveraging siloed state resources, and advancing evidence-based health policy approaches.
As Drug Prices Rise, Oklahoma’s Medicaid Agency Advances Alternative Payment Models
/in Uncategorized Oklahoma Blogs Administrative Actions, Cost Containment, Cost, Payment, and Delivery Reform, Medicaid Managed Care, Prescription Drug Pricing, Quality and Measurement, Value-Based Purchasing /by Jennifer ReckEscalating drug prices are forcing state Medicaid agencies to explore new payment models. According to Burl Beasley, director of Pharmacy Services for Oklahoma’s Medicaid program, older Medicaid payment strategies, such as negotiating enhanced rebates and multi-state purchase agreements, are not keeping pace with rising drug expenditures. Beasley cited the strain prescription drug costs were putting […]
Medicaid Alternative Payment Models for Prescription Drugs: Do They Add Value for States?
/in Uncategorized Oklahoma Webinars Administrative Actions, Cost Containment, Cost, Payment, and Delivery Reform, Prescription Drug Pricing, Quality and Measurement, Value-Based Purchasing /by NASHP WritersWednesday, Dec. 12, 2018 2-3 pm (EST) Listen to the Webinar. Download the Slides. As states struggle with the increasing cost of prescription drugs, they are testing various alternative payment models (APMs). The Oklahoma Health Care Authority is a national leader with four alternative payment models in the form of direct contracts with pharmaceutical manufacturers. […]
Q&A: How Rhode Island Tackles Social Determinants of Health through its Accountable Entity Model
/in Uncategorized Rhode Island Blogs Accountable Health, Blending and Braiding Funding, Chronic Disease Prevention and Management, Cost Containment, Cost, Payment, and Delivery Reform, Health Equity, Medicaid Managed Care, Population Health, Quality and Measurement, Social Determinants of Health, Value-Based Purchasing /by Elinor HigginsAcross the country, states are launching new payment models that reward quality, promote care integration, improve access, and address the social determinants of health (SDOH) in an effort to improve population health. One of these ground-breaking initiatives is Rhode Island’s Accountable Entity (AE) Program, created to improve the health of Rhode Islanders enrolled in Medicaid […]
Oklahoma Signs the Nation’s First State Medicaid Value-Based Contracts for Rx Drugs
/in Uncategorized Oklahoma Blogs Administrative Actions, Chronic Disease Prevention and Management, Cost Containment, Cost, Payment, and Delivery Reform, Population Health, Prescription Drug Pricing, State Rx Legislative Action, Value-Based Purchasing /by Jennifer ReckOn the heels of Oklahoma’s first-in-the-nation, value-based purchasing deal to improve adherence to an antipsychotic drug, the state’s Medicaid agency just signed its second value-based contract for a prescription drug used to treat serious bacterial skin infections. While several private insurers have initiated value-based contracting, which links payments to a drug’s effectiveness and outcome, Oklahoma […]
Idaho Develops a Medicaid Value-Based Payment Model for its FQHCs, Based on Cost and Quality
/in Uncategorized Idaho Blogs, Featured News Home Chronic and Complex Populations, Cost Containment, Cost, Payment, and Delivery Reform, Eligibility and Enrollment, Health Coverage and Access, Health IT/Data, Medicaid Managed Care, Medicaid Managed Care, Population Health, Quality and Measurement, Safety Net Providers and Rural Health, Social Determinants of Health, Value-Based Purchasing /by Neva KayeStarting in early 2020, Idaho will launch a new value-based payment model that will compensate federally qualified health centers (FQHCs) and other providers based on how much they improve the cost and quality of care delivered to Medicaid enrollees. The agency plans to sign contracts to implement the model in January, with implementation beginning July […]